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In the terrible years of 1999 and 2000, Australia's heroin trade was moving at a furious pace. On certain streets across the nation, dealers whispered offers to almost anyone who walked past, and sales were made on footpaths with nonchalant ease. "It was the height of the madness," recalls Melbourne outreach worker Richard Tregear. The drug was everywhere, and as purity rose so did the risk of a fatal overdose. In Melbourne, paramedics like Lindsay Bent were frantic. During those "crazy couple of years," Bent says, it wasn't unusual to treat 18 overdoses in a day in the cbd alone. It's not like that now. When Bent last checked his team's supply of naloxone, which is used to reverse the effects of opiate overdose, only a single dose had been used in the previous week.

The change in the heroin trade in late 2000 and early 2001 was as sudden as it was unexpected. Pina Bampi no longer uses heroin, but she remembers the desperation on the streets of Footscray, an inner suburb of Melbourne, when supply of the drug simply dried up. "People were so panicked, so worried about getting sick (from withdrawal)," Bampi says. "It lasted for three or four months, but to us that was forever." Though heroin is more available now, the ripple effects of the drought continue to be felt, most noticeably in national overdose-death rates, which have plunged since 2000. In New South Wales alone, according to National Drug and Alcohol Research Centre data released this month, there was a 67% fall in opiate-related deaths between 1999 and 2002, while the number of users more than halved. Property crime and ambulance call-outs to overdoses are also down thanks to what the federal government says is the only sustained heroin shortage in the Western world.

Making the shortage last will depend on understanding its causes. An Australian National University-Australian Federal Police study to be released this week confirms that the success of police and Customs in stopping heroin at the borders was critical. Between 1992 and 1997, the a.f.p. intercepted 931 kg of heroin; over the next six years they seized 2,467 kg, including around 700 kg in 2000 alone. The historic shortage that followed, the report says, "provided the first opportunity in many decades to see whether supply and enforcement were in any way related." The link has been widely questioned: do busts make any difference on the street? Many illicit drug experts also argue that treatment is more effective than law enforcement efforts, and that attempts to push up the price by cutting supply may force addicts into more crime to fund their habit. But in what it claims is the first study of its kind, the ANU has found that law enforcement efforts "do, in fact, influence the supply of illicit drugs reaching the community and that increased funding for law enforcement will result in further decreases in supply." Until now, it says, support for the supply-reduction approach was "based mainly on expert opinion rather than empirical evidence." The study shows that drug law enforcement benefits both drug users and the community, "and can now claim scientific evidence on par with that accorded many medical treatments." Whether dips in opium cultivation in key heroin-producing regions like the Golden Triangle - the region where Burma, Laos and Thailand meet, and traditionally Australia's main heroin source - also played a part wasn't looked at by the ANU study. But the federal government credits closer cooperation between Customs and federal police and a bigger a.f.p. presence overseas, as well as the simple size advantage Australia has over countries like the U.S. and Britain in coordinating its law-enforcement program. "In the U.S. they have 18,000 police forces; we have only nine," says Justice and Customs Minister Chris Ellison. "With 13 people around the Australian Crime Commission table, we can have a truly national law-enforcement approach - not many countries can do that."

The latest national figures on heroin use won't be out until November, but in Victoria, where fatal overdose figures slumped from 359 to 49 between 1999 and 2001, deaths last year crept back up to 100. So could heroin make a comeback? Many argue it never really went away. Andrew Murray, executive director of Victoria's Youth Substance Abuse Service, which provides treatment, housing and support to about 2,000 young people each year, says heroin abuse remains common among young people with histories of abuse and violence, who use the drug to numb their emotions. When there was a glut of the drug, Murray says, far more people than usual were able to find and try it. Now, he says, "you have to know where to go and who to talk to." That means little has changed for the service: "Our kids have always been able to get it when they want it."

Tregear, who works with Open Family, a street-based service for children, young people and their families in Footscray, has been helping the disadvantaged in Melbourne's western suburbs for more than two decades. The heroin supply recovered quickly there, he says, but purity - an indicator of supply levels, because dealers dilute with other substances when supply falls - has never returned to the "wild levels" of the late 1990s. He believes fewer overdose deaths and the record numbers of users entering treatment have taken the heroin problem off the front pages. "People think it's all O.K., but that's not the case." A few steps from his office, behind a main street crammed with busy restaurants and small retailers, two chairs have been put in a grim but secluded dead-end alley. The spot is a favorite with local addicts, whose used syringes litter the ground. Tregear and his colleagues help some of them into treatment, despite long waiting lists, and then back to school or work. In the past six months, the outreach team has counted about 70 new users in the area. Tregear agrees with predictions that overdose deaths in Victoria will rise again this year, perhaps to 150.

That number of heroin deaths was last seen in Victoria in 1995, and Paul Dietze, head of the epidemiology unit at Turning Point, one of Australia's leading drug and alcohol agencies, says it's difficult to know where heroin use is heading: "We might be just in the trough of a cycle at the moment." Pina Bampi could easily have been one of those statistics, and many of the 33-year-old's friends still use the drug every day. Bampi used heroin for seven years, during which time she traveled to Israel for rapid detoxification. Three years ago, when she became pregnant, she joined the methadone program. But she says her user friends have no trouble getting drugs. She dismisses claims of a shortage: "It hasn't slowed down, and it hasn't gone away." What has changed, says Bampi, is the way the drug moves around the streets. The footpath used to be the marketplace, but since police in Footscray and other known suburban hotspots began cracking down with more patrols, undercover surveillance and arrests, dealing has moved to darker corners. There, says Tregear, it's harder for police, health professionals and drug workers to find addicts. "You used to almost get killed in the rush of people selling out there," he says. Bampi's friends now ring contacts to organize deals, arranging to buy in cars, parks or busy shops. "It might take a little bit longer, but within half an hour you'll have something," says Bampi. When the drought temporarily starved them of a daily fix, Bampi and her friends began searching for other ways to get stoned. Bampi started using benzodiazepines, sedatives usually prescribed for insomnia and anxiety, topping up whatever heroin she could find: "I used to mix them with smack, take five pills with a hit. The next day I'd be completely blank about what I'd been doing." Some of her friends tried the same crude cocktail, while others began experimenting with stimulants, especially ice, the potent crystallized form of methamphetamine. When the heroin started trickling back, they didn't return to it.

While amphetamine use was growing well before 2000, the post-drought switch to different drugs has many health professionals and drug agencies deeply worried. Amphetamine abuse in particular has severe side effects, including aggression and psychosis. No one knows the full extent of the post-drought migration from heroin to other illicit drugs. The National Drug and Alcohol Research Centre has examined this trend, but its long-awaited report has yet to be made public. Treatment admissions suggest many users have tried to break their habits since heroin supply fell, but drug workers see plenty of others who inject stimulants instead. "Our clients are saying, why waste our money on heroin when it's not very good quality and when ice is so cheap?" says Wendy Macken, head of Directions A.C.T., Canberra's largest non-government drug and alcohol service. "For them it doesn't matter what the effect is, as long as it takes them away from what they were feeling." The result, she says, is a growing number of amphetamine-dependent troublemakers: "With heroin we were resuscitating people, now we're fending off their attacks." Amphetamines, says Justice Minister Chris Ellison, "are our biggest challenge."

Pina Bampi tried ice and knows many who now can't give it up. "Ice is horrible, horrible," she says. "People are different when they use it - it does something to your mind." A decade ago at one clinic in Adelaide, 80% of patients were being treated for heroin; now just 30% are, while half are amphetamine users. University of Adelaide pharmacology and addictions expert Professor Jason White, who works with the clinic, says abuse of prescription opiates like morphine has also become more of a problem. In central Melbourne, where Lindsay Bent's paramedic team is being trained to handle newer drugs, heroin now appears sporadically, and quiet weeks are mixed with bad ones.

Of course that's good, says Bent, "but it's bad too, in that they're using other things instead, which presents new challenges to us." Reducing heroin deaths has been a big win. But heroin isn't the only problem, says Turning Point's Paul Dietze: "use of injected drugs is the issue." And given that those amphetamines are mostly produced within Australia's borders, the new front line will be harder to define.

• Lisa Clausen
• In Australia, vigilant policing has helped create a heroin shortage, but use of other drugs is growing